Rutledge, PA · Delaware County
Private Sewer Lateral Inspection Form
This form records a private sewer lateral inspection, including pipe observations and possible inflow sources, for the building owner and inspector.
What this form is
Use this form to document a private sewer lateral inspection and its findings. It collects building and inspector details, sewer type, inspection observations, and checks for possible inflow sources. The form also describes the required CCTV video and asks for an inspection summary and the master plumber’s signature, printed name, and contact information; it does not state when the inspection is required.
Who needs it
Building owners and sewer lateral inspectors can use this form to record inspection details, observations, and a serviceability summary.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form does not require notarization; the master plumber signs and dates it, and no sworn or notarized attachment is identified.
How to submit this form
- 1
Download The Form
Download the Private Sewer Lateral Inspection Form PDF.
- 2
Complete Inspection Details
Fill in the building and inspector information, sewer type, inspection observations, and summary.
- 3
Gather The CCTV Video
The form says to submit a copy of the CCTV inspection video with the report.
- 4
Submit To The City
Check the city website for current contact details and where to submit the form and video.
Frequently asked questions
- What does the Private Sewer Lateral Inspection Form record?
- It records building and inspector details, sewer type, CCTV inspection observations, possible inflow sources, and a summary of the lateral’s serviceability.
- Who fills out the sewer lateral inspection form?
- The form collects information about the building owner and PSL inspector, and includes a master plumber’s signature, printed name, and contact details.
- Do I need a notary for the Private Sewer Lateral Inspection Form?
- No. The form does not require notarization; the master plumber signs and dates it, and it identifies no sworn or notarized attachment.
- How do I submit the sewer lateral inspection form?
- The form does not provide a submission department, address, email, or portal. Check Rutledge’s website for current contact details.